[Malaria chemoprophylaxis: tolerance and compliance with mefloquine and proguanil/chloroquine combination in French tourists].
To determine if mild adverse events attributed to mefloquine (MQ) and chloroquine + proguanil (CQ-PRO) were experienced with the same frequency, we carried out a study in two groups of French native adult short-term visitors to Africa originating from Amiens. CQ (100 mg daily) + PRO (200 mg daily) prophylaxis was prescribed for all patients travelling to Senegal and those for Kenya when MQ was contraindicated, including all the patients with an history of any neuropsychiatric events, even mild (group 1). MQ (250 mg weekly) was prescribed for the others subjects (group 2). The self-reported questionnaire has been sent by mail to 534 travellers between one to three months after the end of their travels for obtaining information about travel conditions and health problems, mainly those attributed to anti-malarial drugs taken for chemoprophylaxis. We have received 377 available responses (71%): 183 in group 1 and 194 in group 2. There are no significant differences for age, sex, exposition and measures of protection against mosquito bites, concomitant drug use, mean duration of chemoprophylaxis. The compliance during the travel is excellent in each group. CP was interrupted prematurely (< 15 days after returning) in 13.8% of the case with MQ against 4.2% only with CQ-PRO (OR = 3.7; CI 95% = 1.5-9.1). The rates of overall side effects attributed to malaria chemoprophylaxis are respectively: 15.8% for MQ against 12.4% for CQ-PRO (difference not significant). However non-serious neuropsychiatric adverse events (dizziness, headache, mood change and sleep disturbance) are more frequent with MQ: 11.5% against 2.1% with CQ-PRO (OR = 6.2; CI 95% = 2.2-17.2). Although all side effects were transient and judged to be mild to moderate by the subjects themselves, these results back up the fact that mefloquine should be used with caution.
Carme
B
B
Service de parasitologie et mycologie, CHU d'Amiens.
Péguet
C
C
Nevez
G
G
D000328:Adult; D000962:Antimalarials / Q000009:adverse effects*; D002738:Chloroquine / Q000009:adverse effects*; D004338:Drug Combinations; D005260:Female; D005602:France / Q000208:ethnology; D006801:Humans; D007630:Kenya; D008288:Malaria / Q000188:drug therapy* / Q000517:prevention & control*; D008297:Male; D015767:Mefloquine / Q000009:adverse effects*; D010349:Patient Compliance; D002727:Proguanil / Q000009:adverse effects*; D012675:Senegal; D011795:Surveys and Questionnaires; D014195:Travel
D000962:Antimalarials; D004338:Drug Combinations; D002738:Chloroquine; D002727:Proguanil; D015767:Mefloquine
Chimioprophylaxie du paludisme: tolérance et observance de la méfloquine et de l'association proguanil/chloroquine chez des touristes français.